| NPI | 1205623931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDDY RUKEMA KANIKI CEO 907-412-1128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2025-04-24 |
| Last Update Date | 2025-04-24 |